Publikation

Echocardiography does not predict mortality in hemodynamically stable elderly patients with acute pulmonary embolism

Wissenschaftlicher Artikel/Review - 27.07.2016

Bereiche
Schlagwörter (Tags)
Echocardiography; Mortality; Pulmonary embolism
PubMed
DOI
Kontakt

Zitation
Osterwalder J, Hofmann E, Limacher A, Méan M, Kucher N, Righini M. Echocardiography does not predict mortality in hemodynamically stable elderly patients with acute pulmonary embolism. Thromb Res 2016; 2016 145:67-71.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
Thromb Res 2016; 2016 145
Veröffentlichungsdatum
27.07.2016
Seiten
67-71
Verlag
Elsevier
Kurzbeschreibung/Zielsetzung

BACKGROUND:

The evidence on the prognostic value of transthoracic echocardiography (TTE) in elderly, hemodynamically stable patients with Pulmonary Embolism (PE) is limited.

OBJECTIVES:

To evaluate the prevalence of common echocardiographic signs of right ventricular (RV) dysfunction and their prognostic impact in hemodynamically stable patients aged ≥65years with acute PE in a prospective multicenter cohort.

METHODS:

TTE was performed by cardiologists. We defined RV dysfunction as a RV/left ventricular ratio >0.9 or RV hypokinesis (primary definition) or the presence of ≥1 or ≥2 of 6 predefined echocardiographic signs (secondary definitions). Outcomes were overall mortality and mortality/non-fatal recurrent venous thromboembolism (VTE) at 30days, adjusting for the Pulmonary Embolism Severity Index risk score and highly sensitive troponin T values.

RESULTS:

Of 400 patients, 36% had RV dysfunction based on our primary definition, and 81% (≥1 sign) and 53% (≥2 signs) based on our secondary definitions, respectively. Using our primary definition, there was no association between RV dysfunction and mortality (adjusted HR 0.90, 95% CI 0.31-2.58) and mortality/non-fatal VTE (adjusted HR 1.09, 95% CI 0.40-2.98). Similarly, there was no statistically significant association between the presence of ≥1 or ≥2 echocardiographic signs (secondary definitions) and clinical outcomes.

CONCLUSION:

The prevalence of echocardiographic RV dysfunction varied widely depending upon the definition used. There was no association between RV dysfunction and clinical outcomes. Thus, TTE may not be suitable as a stand-alone risk assessment tool in elderly patients with acute PE.